La Realidad del Laboratorio de Anatomía

Patológica 100% Digital. Presente y Futuro

en Granada Dr Juan Antonio Retamero – Patólogo

Hospital Parque Tecnológico de la Salud, Granada

Disclaimer

Granada, Spain – Please come and visit!

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Granada Campus Hospital

21 Pathologists

8 Residents

26 Technicians

2 Porters

4 Clerical

Meet our team

Motril Hospital

2 Pathologists

3 Technicians

Baza Hospital

1 Pathologists

3 Technicians

1 Clerical

Fully Digital for Biopsy and Autopsy

H&Es

Since July 2016

A little bit about myself…

A little bit about myself…

A little bit about myself…

Province of Granada Laboratory Fusion (2011 – 2013)

VNH 944 beds

Motril General 187 beds

75km

Granada Campus de la Salud

Central Pathology Lab, Granada:

Biopsy samples: 43202

Citology samples: 48652

Autopsies: 101

Baza General Hospital

Biopsy samples: 3890

Citology samples: 3789

Autopsies: Centralized

Motril General Hospital

Biopsy samples: 9549

Citology samples: 38326

Autopsies: Centralized

Baza General 117 beds

919,455 inhabitants (2014)

1948 hospital beds

Public Tender awarded to Philips

Granada Campus Hospital 700 Rooms

26 Operating theatres

132 Outpatient consulting rooms

The New Hospital (December 2015)

The Astral Alignment

Sun

Moon

Earth

Department of Pathology

Andalusian Health Service Investing Institution

Public tender awarded to Philips

57,000 biopsies per year in Granada

Province

Approximately 74,000 digitized

biopsies so far

(Almost) complete sample traceability

Our LIS

Vitropath – reporting

VTS – lab management

Integrated with Central Patient

Database (DIRAYA)

Electronic request form

Cascade of events

Our 100% Digital Lab

Integration Philips-Vitropath

VitroPath® LIS Philips IntelliSite Image

Management System

Integration of patient & biopsy data

Hardware Setup

Granada Central Hospital

2x Philips UFS

Granada Central Hospital

1x Sysmex Dark Field Scanner

Baza Hospital

1x Philips UFS

Motril Hospital

1x Philips UFS

Hardware Setup

Immediate Access Storage

350 TB

Long Term Storage

1PB

57,000 Cases per year

6GB per Case

Solution Design Architecture

What does 100% digital mean to Granada and our patients?

Baza Hospital slides are processed

peripherally but assessed centrally by

specialist team

Motril Hospital pathologists have instant

expert opinion, because their cases are

immediately available at Granada

Our pathologists have access to their

biopsies when on call, at home…

What does 100% digital mean to Granada and our patients?

(Subjective) Improvement in Workflow

Use of digital tools

Possibility to conduct consultations

outside our hospital network

(Philips Consultation Suite)

100% Digital means some workflows are

redundant and not repeated

What does 100% digital mean to Granada and our patients?

Images for illustrative purposes only, not for IVD

Griffin J, Treanor D. Digital pathology in clinical use: where are we now and what is holding us

back? Histopathology. 2017 Jan;70(1):134-145

Acceptance by Pathologists

Barriers to implementation

Validation Studies

Change in Habits

A Digital Pathology Concerto

Central Patient History Database

Laboratory Information System

(LIS)

Intelligent Dispatching Algorithm

(Under development, Philips Reasearch)

Open & Recognizable to each other

(HL7 messaging)

Image Viewer (Philips IMS)

A Digital Pathology Concerto

A Digital Pathology Concerto

A Digital Pathology Concerto

Digital journey in Granada

100% Biopsies & Autopsies…

… but full digitization is only the beginning

On the road to Computational Pathology

On the road to Computational Pathology

Sample Traceability

Digital Pathology

Computational Pathology Workflow optimization

Use of diagnostic algorithms

Image analysis

Platform results

Genomic

Proteomic

Metabolomic

Integration of Patient Info

BIG DATA

Workflow representation at Granada

Workflow representation – VitroPath® LIS

Workflow representation – VTS LIS

Workflow representation – Philips IntelliSite

Intracentre flow and virtual slide trays

Next steps: Integration of CE-IVD algorythms

Algorithms for Breast IHC panel

HER2

ER

PR

Ki-67

Next Steps: Automatic Quantification of Skin Basal Cell Carcinoma

Granada’s own internal

development and progress in

Computational Pathology

Next Steps: Automatic Quantification of Skin Basal Cell Carcinoma

Granada’s own internal

development and progress in

Computational Pathology

Next steps: Automatic Mitotic Counting with Phospho-histone H3 in Melanoma

Granada’s own internal

development and progress in

Computational Pathology

Conclusion

Digital pathology is not an end in itself, but rather the

beginning of computational pathology, that will produce

Big Data for each tumour, for each patient, for each

organization for both personal and collective use

(personalized medicine, clinical trials, epidemiology and cancer genetics, etc.)

Think computational pathology!

Take home messages

Get the right tools for the job

Get the right partner

Thank you

Microscopes for sale Granada, Spain!